Abstract Background and aim: Alcoholic liver disease (ALD) represents a frequent indication for liver transplantation (LT). Since 2004, we have adopted a program of multidisciplinary support(MS) to assist patients undergoing LT for ALD. We aimed at analyzingthe relapse rate and the risk factors for relapse. The relapse rate was also compared with that of a historical group of patients who underwent transplantation. Their survival rate was also analyzed.Patients and methods: Consecutive patients with ALD transplanted from 2004 were included. The most important demographic, psychosocial, and clinical characteristics known to be associated with alcohol relapse were recorded. Results: Sixty-nine patients underwent MS: 8.7% presented alcohol relapse. At multivariate analysis female gender (sHR 9.02, 95% CI 1.71-47.56,P = .009), alcohol withdrawal syndrome (sHR 5.89, 95% CI 1.42-24.46, P = .015) and a shorter time of MSprogram before LT (sHR 0.928 per month, 95% CI 0.870-0.988, P = .021) were identified as independent risk factors for relapse. The rate of alcohol relapse was significantly lower than that of the historical group who did not undergo MS (sHR 0.21, 95% CI: 0.06-0.68; P = .009).Conclusion: This study shows that a MS program may contribute to alcohol relapse prevention after LT in ALD patients. However, the relevance of this support needs to be confirmed by clinical trials. K EYWORDS alcohol abuse, alcohol dependence, alcohol relapse after liver transplantation

The multidisciplinary support in preventing alcohol relapse after liver transplantation: a single centre experience / Attilia, M; Lattanzi, B; Ledda, R; Galli, A; Farcomeni, A; Rotondo, C; Di Gregorio, V; Mennini, G; Poli, E; Attilia, F; Ginanni Corradini, S; Rossi, M; Merli, M. - In: CLINICAL TRANSPLANTATION. - ISSN 0902-0063. - STAMPA. - 32:5(2018), pp. 1-7. [10.1111/ctr.13243]

The multidisciplinary support in preventing alcohol relapse after liver transplantation: a single centre experience

Attilia, M
Primo
Writing – Review & Editing
;
Lattanzi, B
Secondo
Investigation
;
Ledda, R
Investigation
;
Farcomeni, A
Formal Analysis
;
Rotondo, C
Investigation
;
Di Gregorio, V
Investigation
;
Mennini, G
Investigation
;
Poli, E
Investigation
;
Attilia, F
Investigation
;
Ginanni Corradini, S;Rossi, M
Penultimo
Supervision
;
Merli, M
Ultimo
Writing – Review & Editing
2018

Abstract

Abstract Background and aim: Alcoholic liver disease (ALD) represents a frequent indication for liver transplantation (LT). Since 2004, we have adopted a program of multidisciplinary support(MS) to assist patients undergoing LT for ALD. We aimed at analyzingthe relapse rate and the risk factors for relapse. The relapse rate was also compared with that of a historical group of patients who underwent transplantation. Their survival rate was also analyzed.Patients and methods: Consecutive patients with ALD transplanted from 2004 were included. The most important demographic, psychosocial, and clinical characteristics known to be associated with alcohol relapse were recorded. Results: Sixty-nine patients underwent MS: 8.7% presented alcohol relapse. At multivariate analysis female gender (sHR 9.02, 95% CI 1.71-47.56,P = .009), alcohol withdrawal syndrome (sHR 5.89, 95% CI 1.42-24.46, P = .015) and a shorter time of MSprogram before LT (sHR 0.928 per month, 95% CI 0.870-0.988, P = .021) were identified as independent risk factors for relapse. The rate of alcohol relapse was significantly lower than that of the historical group who did not undergo MS (sHR 0.21, 95% CI: 0.06-0.68; P = .009).Conclusion: This study shows that a MS program may contribute to alcohol relapse prevention after LT in ALD patients. However, the relevance of this support needs to be confirmed by clinical trials. K EYWORDS alcohol abuse, alcohol dependence, alcohol relapse after liver transplantation
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/1092025
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